REI and Onc Flashcards
(32 cards)
Primary Amenorrhea, DDx and how to make the diagnosis?
No breast, but has a uterus
ovarian failure - FSH increased
pituitary failure - GNRH stim- LH does not increase
hypothalamic failure - GNRH stim- LH increases
Primary Amenorrhea, DDx and how to make the diagnosis?
breast present, uterus absent
mullerian agenesis (MRKH) vs AIS
karyotype or testosterone level, but testosterone level is cheaper
absent uterus means either mullerian agenesis or Y chromosome present
Primary Amenorrhea, DDx and how to make the diagnosis?
no breast, no uterus, but with normal external female genitalia
gonadal agenesis, agonadism, rare gonandal enzyme deficiency
Primary Amenorrhea, DDx and how to make the diagnosis?
breast and uterus present
Normal genotype/phenotype
bcg, tsh, prolactin, progesterone challenge (bleeding within 2 weeks)
no menses or secondary sex characteristics by 14
or secondary sex characteristics by 16.
Lynch syndrome markers
MLH-1
MSH-2
MSH-6
PMS-2
tumor marker association
HE4
APC
CDKN
human epidimis - epithelial ovarian cancers
APC- familial adenomatous polyps
Peutz-Jeghers
Most common in the ovary
malignancy
primary malignancy
neoplasm
mass of the ovary
malignancy - metastatic
primary malignancy - serous cystadenocarcinoma
neoplasm- mature teratoma
mass of the ovary - functional cyst
germ cell tumor markers
dysgerminoma
yolk sac
choriocarcinoma
hcg and LDH (german betta had long distance)
AFP, schiller duvall bodies
hcg
germ cell tumor markers
immature teratoma
embryonal carcinoma
AFP, CA 125 (immature ladies Are From Pasadena, CA)
hcg, AFP
tumor marker
mucinous
CEA
histogenesis of these epithelial ovarian cancers
serous mucinous endometriod clear cell brenner
serous - ciliated tubal epithelium (psammoma bodies)
mucinous- columnar endocervical epithelium (pseudomyxoma peritonei)
endometrioid- endometrial glands
clear cell- mesonephric tissue
brenner-transitional urothelium (Walthard Cell rests)
endo bx and risk of cancer simple hyperplasia without atypia complex hyperplasia without atypia simple with complex with
1%
5%
10%
25-40%
septic shock
PCWP
CO
SVR
septic shock
PCWP - decreased
CO - increased
SVR - decreased
cardiogenic shock
PCWP
CO
SVR
cardiogenic shock
PCWP - increased
CO - decreased
SVR -increased
hypovolemic shock
PCWP
CO
SVR
hypovolemic shock
PCWP - decreased
CO - decreased
SVR - increased
Quick Onc Associations
- Hob nail cells
- leydig cells
- pseudoxanthoma cells
- fibrous septae and lymphocytes
- nesting tumors
- Hob nail cells- clear cell
- leydig cells- hilus cell
- pseudoxanthoma cells- endometrioid
- fibrous septae and lymphocytes- dysgerminoma
- nesting tumors- brenners and granulosa
chemotox
- adriamycin
- vincristine
- vinblastine
- cisplatinum
- 5-FU (2)
- cyclophosphamide (3)
- cardio
- high neuro, low bone
- high bone marrow, low neuro
- renal
- cerebellar ataxia and myelosuppresion
- hemorrhagic cystitis, SIADH, myelosuppression
what's happening in each cell phase? G0 G1 S G2 Mitosis
G0 - resting phase-cell may skip this phase
G1 - gap between mitosis and S phase, no DNA replication but the cell is active
S - DNA replication
G2 - protein synthesis and prep for mitosis
M- cell division
cyclophosphamide
class mechanism of action phase most active
cyclophosphamide
- alkylating agent
- interacalates DNA
- S phase
methotrexate and gemcitabine
class mechanism of action phase most active
methotrexate and gemcitabine
- antimetabolites
- dihydrofolate reductase–> cant make purines, inhibit DNA synthesis
- s phase
cis and carboplatinum
class mechanism of action phase most active
cis and carboplatinum
- platinum
- DNA helix distortion and base pair bonding
- any phase
another name for adriamycin
class Mechanism of action phase most active
doxorubicin
- anti-tumor abx
- inhibits topoisomerase II- dna breaks, free radicals formation
- G1
how does bleomycin work?
phase most active?
uses copper and iron to create superoxide free radicals
G2
how do vincristine and vinblastine work?
what phase?
binds to tubulin subunits to block mitosis
M phase
